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Biomedical subjects

A D Cheesman

Publications and source records attributed to A D Cheesman.

At least 55 records · Page 3Linked to original sources
PubMed1987

Craniofacial resection of extensive benign lesions of the anterior skull base.

The craniofacial resection operation was developed for the treatment of advanced nasal, paranasal and orbital malignancies. It has been refined in recent years, giving increased cure rates and better palliation when cure is not possible. When used to treat extensive benign lesions involving the anterior skull base, this procedure allows more complete and safer resection with better access for repair and avoidance of major complications of brain damage, cerebrospinal fluid leak and haemorrhage. Presented here is a technique for craniofacial resection. The study demonstrates its effectiveness and low morbidity in treating 10 patients with extensive benign disease.

Adolescent↗
PubMed1986

Epiglottopexy: a modification using additional hyoid suspension.

A case of non-progressive severe laryngeal incompetence is described in which, in addition to the already established operation of epiglottopexy and cricopharyngeal myotomy, a laryngeal suspension using a carbon fibre implant is performed. This provides additional protection to the laryngeal inlet, thus obviating the need for a long-term tracheostomy.

Aged↗
PubMed1986

Glomus vagale: an unusual presentation.

An unusual case of glomus vagale tumour is presented where severe pain was a predominant feature. The pathological and clinical features of this rare tumour are reviewed and the investigations and treatment are discussed.

Adult↗
PubMed1986

Tracheo-oesophageal 'puncture speech'. An assessment technique for failed oesophageal speakers.

We describe the assessment procedures used at Charing-Cross Hospital to investigate laryngectomees who failed to develop oesophageal voice and give the results of assessment in 50 patients. Anatomical or physiological abnormalities in the reconstructed pharynx were found in all patients, and we feel these significantly contributed to the failure of achieving an oesophageal voice. The four cases of failure were due to hypotonicity of the pharyngo-oesophageal muscles, hypertonicity, frank spasm and stricture. This distinction can be used as a functional classification of failure as treatment for each group has to be different if successful surgical voice restoration is to be achieved. Patients with hypotonicity need to use external pressure; those with mild hypertonicity are able to use a low pressure tracheo-oesophageal voice prosthesis; those with spasm need a pharyngo-oesophageal myotomy prior to "puncture", while those with stricture need surgical correction.

Esophagus↗
PubMed1982

A modification of the Blom-Singer valve for restoration of voice after laryngectomy.

The authors have been involved in developing a modification of the Blom-Singer valved prosthesis for restoration of voice after laryngectomy. This is a case report on the first patient who underwent this procedure in Britain. It was found essential that a different design of valved prosthesis be invented and this is described. Aspects for consideration when selecting a potential candidate for this procedure are outlined, and guidelines given for choosing suitable patients.

Aged↗
PubMed1978

Changes in otological teaching following analysis of failures in surgical technique.

An analysis was made of the results of mastoid surgery performed in the Professorial Unit of the Royal National Throat, Nose and Ear Hospital, London, between the years 1970 and 1974. Most of the surgery was performed by trainee surgeons at the end of the teaching programme. The incidence of unsatisfactory results was greater with open mastoid surgery than with closed mastoid surgery. The causes of failure were analysed, and the underlying defects in the teaching programme identified. The subsequent modification in the teaching methods that resulted are illustrated.

Cholesteatoma↗
PubMed1977

Intra-vital staining as an aid to parotid gland surgery.

Successful parotid surgery depends on the careful identification and dissection of the facial nerve, and to prevent recurrence all tumours should be excised with a wide margin of normal tissue. These two requirements are facilitated by the technique of intra-vital staining of the parotid gland with 2.5% methylene blue solution.

Adenocarcinoma↗
PubMedDate not supplied

Magnetic resonance imaging of paranasal sinus tumors for craniofacial resection.

Computerized tomography (CT) has been shown to be 78% accurate with respect to anatomic extent of tumor when correlated with operative findings and histology in patients undergoing craniofacial resection. To determine whether preoperative evaluation could be improved by the combination of CT and magnetic resonance imaging (MRI), 26 patients with tumor of the paranasal sinuses had undergone MRI before surgery in addition to CT. Ten patients also received Gadolinium-DTPA as a contrast-enhancement agent during MRI. The radical approach offered by craniofacial resection allows accurate evaluation of imaging techniques and when these are compared with histologic findings, a 94% correlation is found. The use of Gadolinium further improves the accuracy of tumor delineation to 98%. Despite the intrinsic disadvantage of absent bone detail, MRI demonstrates the extent of tumor better than CT and can distinguish it from inflammed mucosa, retained secretions, and normal mucosa provided the correct sequences are used.

Adolescent↗
PubMedDate not supplied

Craniofacial resection for tumors of the nasal cavity and paranasal sinuses.

The craniofacial approach for resection of tumors of the nose and paranasal sinuses is well established, as are its advantages over previous methods of treatment. The technique has been considerably modified, resulting in an operation that combines excellent access, a sound oncologic resection with excellent cosmesis, and low postoperative morbidity for conditions associated hitherto with an extremely poor prognosis. The 7-yr experience of 60 patients is presented. Results suggest improved survival in a group of patients who are potentially curable by this procedure, while in those with extensive disease good palliation is achieved. In addition, large benign tumors that would previously have been considered inaccessible can be resected. Its many advantages recommend it as the treatment of choice for tumors of the nose and paranasal sinuses.

Adenocarcinoma↗